Union Christian College

Brgy. II Widdoes St. City of San Fernando, La Union

2500 Philippines
URL Address: www.ucc.edu.ph
Tel. #s. (63) 072 700-0282, Tel. Fax (63) 072 888-3340

APPLICATION FOR GRADUATION

(FILL IN THE BLANKS CORRECTLY AND COMPLETE, ALL IN CAPITAL LETTERS)

dmdjdkdjjddkdkksjssjsndnkalskdnfnwkwkwk
(FAMILY NAME) (GIVEN NAME) (MIDDLE NAME)
BACHELOR OF SCIENCE IN ACCOUNTANCY

(CANDIDATE FOR THE TITLE/ DEGREE) (MAJOR)

MALE APRIL 03, 1998 DAMACUAG, SANTA LUCIA, ILOCOS SUR

(GENDER) (DATE OF BIRTH)

(PLACE OF BIRTH)

BARANGOBONG, SANTA LUCIA, ILOCOS SUR

(HOME ADDRESS)

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SCHOLASTIC RECORDS:
(HIGH-SCHOOL) NAME OF SCHOOL SCHOOL YEAR

Fourth Year: SANTA LUCIA ACADEMY 2013-2014

Third Year: SANTA LUCIA ACADEMY 2012-2013

Second Year: SANTA LUCIA ACADEMY 2011-2012

First Year: SANTA LUCIA ACADEMY 2010-2011

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DID YOU ENROLL IN ANY OTHER INSTITUTION (AFTER YOU HAVE GRADUATED FROM HIGH SCHOOL) BEFORE YOU WERE
ADMITTED IN UNION CHRISTIAN COLLEGE? √ YES NO.

IF YES, PLEASE WRITE DOWN THE NAME AND ADDRESS OF THE SCHOOL ON THE SPACE PROVIDED BELOW.

NAME OF SCHOOL SEMESTER SCHOOL YEAR

SAINT LOUIS UNIVERSITY 2014-2016

SAINT LOUIS COLLEGE 2016-2018

ADDRESS OF THE SCHOOL

BAKAKENG, BAGUIO CITY, BENGUET

CARLATAN, CITY OF SANFERNANDO, LA UNION

NOTE:

THOSE WHO HAVE MORE THAN NINE (9) UNITS DEFICIENCIES ARE NOT ALLOWED TO PARTICIPATE IN THE
COMMENCEMENT EXERCISE.
 Union Christian College
Brgy. II Widdoes St. City of San Fernando, La Union
2500 Philippines
URL Address: www.ucc.edu.ph
Tel. #s. (63) 072 700-0282, Tel. Fax (63) 072 888-3340

WAIVER

I, JIMWELL PETINES CORTEZ

(GIVEN NAME) (MIDDLE NAME) (FAMILY NAME)

A SENIOR STUDENT TAKING UP BACHELOR OF SCIENCE IN ACCOUNTANCY

RESPECTFULLY
COURSE
REQUEST THAT I BE ALLOWED TO JOIN THE GRADUATION RITES IN _____________ _____ 20 .

I EXPECT TO FINISH ALL THE REQUIREMENTS FOR GRADUATION AT THE END OF:
( ) FIRST SEMESTER SY: ( ) SECOND SEMESTER SY:

I STILL HAVE UNIT/ S DEFICIENCY/ IES TO COMPLETE ALL THE REQUIREMENTS OF MY COURSE AS OF ___
MY DEFICIENCY/ IES IS/ ARE AS FOLLOWS:

COURSE NO. DESCRIPTIVE TITLE UNITS

SHOULD MY APPLICATION TO PARTICIPATE IN THE GRADUATION RITES BE APPROVED, I SHALL VOLUNTARILY AND WILLINGLY SUBJECT
MYSELF TO THE FOLLOWING CONDITIONS:

1. THAT MY PARTICIPATION IN THE GRADUATION RITES DOES NOT NECESSARILY MEAN OR IMPLY THE COMPLETION OF ALL
THE REQUIREMENTS FOR GRADUATION.
2. THAT I SHALL NOT CLAIM NOR DEMAND FOR A DIPLOMA OR A CERTIFICATE UNLESS AND UNTIL MY APLLICATION FOR
GRADUATION SHALL HAVE BEEN APPROVED AND CONFIRMED BY A SPECIAL ORDER ISSUED BY THE COMMISSION ON
HIGHER EDUCATION OR BY A REGISTRY OF GRADUATES CONTROL NUMBER ISSUED BY UNION CHRISTIAN COLLEGE.
3. THAT MY APPLICATION FOR THE ISSUANCE OF SPECIAL ORDER FOR GRADUATION OR REGISTRY OF GRADUATES
CONTROL NUMBER SHALL BE FILLED BY THE REGISTRAR ONLY UPON PROPER EVALUATION AND RECOMMENDATION BY
THE DEAN AND UPON SUBMISSION OF ALL SUPPORTING PAPERS THAT MAY BE REQUIRED BY THE REGISTRAR'S OFFICE
PURSUANT OF EXISTING RULES AND REGULATIONS OF THE COMMISSION ON HIGHER EDUCATION AND AFTER THE FINAL
EVALUATION OF THE REGISTRAR.
4. THAT SHOULD MY APPLICATION FOR THE ISSUANCE OF SPECIAL ORDER FOR GRADUATION OR REGISTRY OF GRADUATES
CONTROL NUMBER BE DISAPPROVED DUE TO DEFICIENCY/ IES, OR SHOULD I OBTAIN A FAILING GRADE AND/OR
INCOMPLETE MARK AT THE END OF THIS TERM OR SHOULD ANY UNFORESEEN CIRCUMSTANCES PREVAIL/ INTERFERE,
OR ADVERSELY AFFECT THE COMPLETION OF MY COURSE, WHETHER WILLFULLY OR NOT, I PROMISE TO COMPLETE ALL
MY DEFICIENCIES AS INDICATED BY THE REGISTRARS’ OFFICE DURING THE NEXT TERM IMMEDIATELY FOLLOWING MY
PARTICIPATION IN THE GRADUATION RITES.
5. THAT I WILL FILE AND SUBMIT THIS APPLICATION FORM TO THE REGISTRARS’ OFFICE IMMEDIATELY.

JIMWELL CORTEZ
Candidate’s Signature over Printed Name

Noted:
DEAN Date

REPUBLIC OF THE PHILIPPINES)

PROVINCE OF LA UNION ) SS
CITY OF SAN FERNANDO )

SUBSCRIBED AND SWORN TO BEFORE ME A NOTARY PUBLIC IN SAN FERNANDO CITY, LA UNION, PHILIPPINES, ON THIS DAY OF
20 AFFIANTS EXHIBITING THEIR RESIDENTIAL CERTIFICATE NO. .

DOC. NO.
BOOK NO.
PAGE NO.
SERIES NO. Notary Public
Union Christian College
Brgy. II Widdoes St. City of San Fernando, La Union
2500 Philippines
URL Address: www.ucc.edu.ph
Tel. #s. (63) 072 700-0282, Tel. Fax (63) 072 888-3340